title: Carpal tunnel syndrome. Evaluation of a quantitative provocational diagnostic test.
abstract: A diagnostic test combining the sensitivity of the Semmes-Weinstein monofilament measurement and the specificity of the wrist flexion provocational test has been evaluated in a group of 21 patients (33 hands) with electrodiagnostically verified carpal tunnel syndrome and 30 asymptomatic hands (controls). Semmes-Weinstein monofilament testing consisted of several sensory threshold measurements obtained by the application of force-calibrated Semmes-Weinstein monofilaments to each digit in the hand with the wrist in neutral position. The quantitative provocational diagnostic test employed Semmes-Weinstein measurements obtained with the wrist both in the neutral and flexed positions. The sensitivity (82%) and specificity (86%) of the combined test were calculated. It was more sensitive and specific than the wrist flexion test alone and more specific than the Semmes-Weinstein sensibility test. The combined test is recommended as the most accurate and sensitive quantitative clinical test for median nerve compression evaluated by the authors to date.
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston.
authors.forename: M
authors.initials: M
authors.lastname: Koris
authors.forename: R H
authors.initials: RH
authors.lastname: Gelberman
authors.forename: K
authors.initials: K
authors.lastname: Duncan
authors.forename: M
authors.initials: M
authors.lastname: Boublick
authors.forename: B
authors.initials: B
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D010808:Physical Examination / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012684:Sensory Thresholds; D014955:Wrist Joint / Q000503:physiopathology